Psychosocial correlates of suicidal risk among university students in a U.S.-Mexico border city: A mixed-methods study

Background Suicide is a major public health concern, yet psychosocial correlates of suicidal risk among university students on the U.S.-Mexico border remain underexamined. This study investigated psychosocial and demographic factors associated with suicidal risk and explored students' lived experiences to inform contextually relevant prevention strategies. Methods This sequential explanatory mixed-methods design study employed an online survey to sample 385 university students using snowball sampling at the quantitative phase, with measures assessing suicidal risk (Plutchik Suicidal Risk Scale), anxiety (GAD-2), depression (PHQ-2), and social support (OSSS-3), alongside demographic and academic variables assessed categorically, ordinally, and continuously. Data were analysed using Pearson correlations and hierarchical multiple regression. The qualitative phase purposively sampled nine students with a history of suicidal behaviour. Semi-structured in-depth interviews were conducted and analysed using an inductive-deductive qualitative content analysis approach. Results Suicidal risk was negatively associated with perceived social support and positively associated with internalising distress. Regression analyses indicated that internalising distress was a significant predictor of suicidal risk, whereas social support, higher academic performance, and scholarship status were protective. Qualitative findings corroborated these results, highlighting the roles of academic stress, psychological distress, limited social support, and barriers to help-seeking. Limitations The cross-sectional design precludes causal inference; snowball sampling and self-report measures may introduce bias; and this single institutional study may lack generalisability. Conclusions Suicidal risk among participants reflected intersecting psychological, social, and academic factors. Universities should prioritise integrated prevention strategies that combine early identification of internalising distress, strengthened social support, academic support, and accessible mental health services.